Blind to impact of cap on Medicare refunds

EVERY month Wahroonga retiree Helen Ingleby has an injection into her eye, which helps save her vision.

The 71-year-old is one of 167,000 Australians with age-related macular degeneration. Another 1 million people over the age of 50 have some symptoms of the disease, which is the leading cause of blindness in Australia.

As of November 1, Mrs Ingleby's out-of-pocket costs for the treatment will increase from about $100 a month to $500 under changes to the federal government's Extended Medicare Safety Net.

The changes will cap the amount the government refunds to patients for payments in excess of the normal Medicare fee.

Mrs Ingleby is concerned that she and many other patients having treatment will struggle to afford the rise.

''How long will I be able to keep paying that amount of money for?'' she said. ''A lot of people won't be able to afford it. They will just go blind.''

Mrs Ingleby has wet aged-related macular degeneration in her left eye and dry age-related macular degeneration in her right eye. She was diagnosed 2½ years ago and has been treated with the injectable medication Lucentis ever since.

Along with capping benefits to eye injectables, the government has also capped refunds to a number of other services under the changes. Items to be capped include a range of GP services, early intervention services for children with autism, pain and palliative services and geriatric medicine.

The caps, announced in this year's budget, are part of a four-year plan to save $96 million, after a review of the Extended Medicare Safety Net showed that expenditure blew out from $231.2 million to $538.6 million between 2004 and 2009.

The chief executive of the Macular Degeneration Foundation, Julie Heraghty, said about 20 per cent of patients being treated with injectables would face an increased out-of-pocket cost.

She said most doctors charged below the $546.05 scheduled fee for eye injections and their patients would not be affected.

''But there are some doctors who charge more,'' she said. ''Every business has some operators which charge a lot and there are justifiable reasons for that.''